There is an entire group of muscle dedicated to supporting and moving your shoulder blades. A number of issues can affect these muscles and the nerves connected to them, which could result in a condition known as winged scapula. This condition is easily recognizable since your shoulder blades will protrude from your back. Here is how you can correct your shoulder blade position.
What Is Winged Scapula?
Scapula is another word for shoulder blade. Your shoulder blades can start protruding, sometimes at a very noticeable angle, if one of the muscles attached to these bones isn’t working properly.
Depending on the severity of the issue affecting one of the muscles or nerves connected to the shoulder blade, the change in alignment might only be noticeable when you stand against a wall or sit straight up in a chair. In some cases such as shoulder injuries, the protruding shoulder blades are accompanied by other symptoms like pain and swelling.
What Are The Symptoms Of Winged Scapula?
In a lot of cases, scapular winging is the only noticeable symptom. The winging can be very minor, and it might take you a while to notice that something is off with your posture.
You might experience a limited range of motion depending on the muscles affected. Pain in your shoulders and weakness can also occur.
What Are The Most Common Causes?
We need to look at the different scapular muscles to better understand the type of injuries that can result in protruding shoulder blades.
Serratus Anterior Muscle
This is a muscle that covers the sides of your rib cages. It covers the area between your first and eighth rib. The purpose of the serratus anterior muscle is to support your shoulder blades.
This muscle can stop functioning properly if you tear it, for instance while throwing a punch. Trauma on the side of the rib cage can also damage the serratus anterior muscle and affect the shoulder blades.
The serratus anterior muscle can also be affected if the long thoracic nerve is injured. This nerve runs along the neck and the sides of the rib cage, which makes it prone to injuries during contact sports.
This is a wide and flat muscle that covers your neck and shoulder blades. The trapezius muscle stabilizes the scapula and rotates it. The trapezius muscle or spinal accessory nerve that is connected to it can sustain damage and no longer support the shoulder blade.
This is not a very common cause behind winged scapula since this isn’t an area where you are likely to experience trauma and not a muscle you can easily pull. The spinal accessory nerve is protected by the trapezius.
The rhomboid muscles cover the space between your shoulder blades. These are the muscles you would engage to pull your shoulder blades together. If you are unable to contract your shoulder blades, your rhomboid muscles are probably damaged.
This isn’t a common cause either since this isn’t an area where you are likely to experience trauma, but this isn’t something you should rule out if you are unable to pull your shoulder blades together.
Ligaments and Joints
Your protruding shoulder blades could be the result of an injury that doesn’t affect muscles. Your posture can change as a result of a dislocated joint or a clavicle fracture.
These are injuries likely to happen in football and other contact sports. A fracture or a dislocated joint would cause severe pain and limit your range of motion. If you experience severe scapular pain after a fall or after colliding with another player, try lifting your arms above your head. If you are unable to perform this movement, get some X-rays done to check your joints and clavicle.
There are other muscles and nerves that can affect how the scapulae sit. However, damage to these muscles and nerves is usually the result of illness and not sports-related injuries.
Getting a Diagnosis
The protruding shoulder blades are easy to recognize and this is something you should notice by yourself. Your doctor will confirm that your shoulder blades are not properly supported by having you sit straight or stand against a wall.
You can do a few things to determine which muscle is affected. If your serratus anterior is damaged, your shoulder blades will protrude when you push your palms against a wall. You won’t be able to rotate your shoulder blades if your trapezius muscle is damaged and won’t be able to contract your shoulder blades if the problem comes from your rhomboids.
Your doctor will ask you to perform different motions to determine which muscles or nerves are affected. X-rays will be needed to diagnose a broken clavicle, and your doctor might schedule an MRI scan to see which muscle tissues or nerves have been damaged.
In most cases, talking about recent injuries or falls and about your activities will be enough for your doctor to properly diagnose you.
How Are Protruding Shoulder Blades Treated?
Correcting your shoulder blade posture takes time. Your damaged muscles or nerves will need time to heal and you will need to work on strengthening the muscles that support your shoulder blades. Ideally, you should stop all physical activities until this problem is corrected.
Manage Your Shoulder Pain
If you experience pain, tenderness, or weakness in your shoulders, avoid putting any strain on the affected muscles. Be mindful of your posture and get as much rest as you can.
Cold treatments and Ibuprofen can help with inflamed muscle tissue. Apply the cold treatments on the muscles that have been damaged and not on the shoulder blades themselves.
Correct Your Posture
Your shoulder blades will protrude until you strengthen the muscles that support these bones. However, you shouldn’t work on these muscles until you are completely healed if you tore a muscle.
It is best to meet with a physical therapist so you can determine exactly which muscles you need to target. Your physical therapist will create a treatment plan so you can gradually correct your shoulder blade posture by developing the right muscles.
Get Started With Physical Therapy
Your physical therapist will probably recommend that you perform some gentle exercises that will stretch different muscles and gradually restore your range of movements. Be mindful of pain and tenderness and don’t push yourself too far when you first start working on your shoulder muscles.
You can gently exercise your rhomboids and trapezius by standing straight, opening up your shoulders and contracting your shoulder blades. Hold for a few seconds before releasing. You can also stand with your back against a wall, raise your arms up without extending your elbow and push your arms back so that your elbows touch the wall.
The best way to stretch your serratus anterior muscle is to throw a punch. However, you should avoid any sudden movements while recovering from a torn muscle. You should slowly extend your arm in a punching motion to engage these muscles.
You will be able to start developing these muscles once you have healed from your shoulder injury. Your shoulder blades might still look like they are not properly aligned, but you can safely exercise once you no longer feel pain in your muscles or nerves.
Strengthen Your Muscles
You can build stronger rhomboids by doing pushups on a regular basis and by lifting weights. Target these muscles by lifting weights in front of you with your elbows bent so that the weights get as close to your chin as possible.
Because the anterior serratus muscle is the muscle you use to throw punches, you can develop this muscle by using an exercise band to add resistance when performing a punching motion. Place the band over your shoulder with your elbow bent and slowly extend your arm in a punching motion.
You can also work on your anterior serratus muscle by laying on the floor and lifting weights or a medicine ball above your chest. Keep your elbows extended and use only your shoulders to lift and lower the weights or medicine ball.
You can develop stronger rhomboids and work on your trapezius muscle at the same time by performing a shrugging movement while holding weights.
Pushups are another great way to target all your shoulder muscles at once. However, a lot of people don’t engage their anterior serratus muscles when doing pushups. You should get in a pushup position and contract your shoulder blades. This simple exercise will help you feel where your serratus is so that you can consciously engage it when you do a pushup.
Take your time before moving on to strengthening your shoulder muscles if you sustained an acute shoulder injury or if you still feel pain. Wear a shoulder brace to maintain a good posture while exercising, and stop what you are doing if you feel pain or weakness.
You should ideally rest for two entire weeks before you start with physical therapy if you injured a shoulder muscle. You will also have to stop practicing any kind of sports until you have healed and gotten a chance to strengthen the muscles that support your shoulder blades.
Noticing that your shoulder blades are protruding can be alarming, but the good news is that this condition can be treated by waiting for damaged muscles or nerves to heal. You should see a doctor to get a proper diagnosis and meet with a physical therapist to create a treatment plan adapted to the type of shoulder injury you sustained.